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(FAYETTEVILLE, TN) -- A police sergeant has been indicted on charges of being nude and exposing himself to the public while in his own home.
Sgt. Jeff Dorning was charged with six counts of public indecency and six counts of indecent exposure after fellow lawmen received complaints from five women and a child who claimed they saw the officer naked, according to the indictment.
Police Chief Doug Carver, who heads the 28-member department in this city of 7,300 located about 70 miles south of Nashville near the Alabama border, said Dorning was suspended without pay until the criminal charges against him are adjudicated. The officer could be fired if convicted, the chief said.
Carver told APBnews.com that the Lincoln County District Attorney's Office and the Tennessee Department of Investigation (TBI) conducted the investigation of Dorning. He said he could not provide further information on the case because the probe began before he became police chief in June.
A woman who answered the telephone at Dorning's Fayetteville home said he wasn't available for comment. Officials said that Dorning has been a police officer in the city for about 10 years.
Actions "offend" ordinary person
In the 12-count indictment issued Sept. 21, Lincoln County grand jurors charged that in February 1999, Dorning "intentionally exposed his genitals or buttocks" to the five women and a 13-year old child. The incidents occurred on Feb. 8, 10, 11 and 16, according to the indictment.
The grand jurors found that that Dorning's actions "would offend an ordinary viewing person or were for the purpose of his sexual arousal or gratification," the indictment said.
The indictment did not say where the alleged indecent acts occurred. However, a Fayetteville police officer with knowledge of the case said that the incidents took place in Dorning's home. It could not be determined whether the victims observed Dorning while looking inside his home.
W. Michael McCown, the district attorney general who presented the case to a grand jury, could not be reached for comment.
Free on bond
Mark Gwynn, spokesman for the TBI, said that it is routine for the bureau to become involved in investigating alleged wrongdoing by local police officers in order to make sure an independent agency looks at the case.
He refused to answer questions about the case.
The clerk's office at the Circuit Court of Lincoln County, where the indictment was filed, said Dorning had been released on $500 bond and the officer had not yet entered a plea to the charges.
Raymond Fraley, identified by local police as Dorning's attorney, was not in his office today and could not be reached for comment.
Tennessee law states that anyone convicted of public indecency or exposure on the first or second offense faces a $500 fine and a third offense could result in a $1,500 fine, a prison term of about a year, or both.
ED Expo Returns to NO
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Right And Left Coalition Propose Over $38 Billion In Cuts For Pentagon
While conservatives and progressives in America may have stark differences, we all agree on reducing waste, fraud, and abuse of taxpayer money.
Report: Pentagon Not Enforcing Revolving Door Corruption Regulations
A recent report reveals the Pentagon is not keeping track of whether former employees are complying with revolving door laws designed to prevent corruption.
Democratic Party Reverses 2008 Restrictions On Lobbying And Corporate Influence
The Democratic National Committee announced it will be reversing restrictions introduced in 2008 that banned donations from federal lobbyists and PAC's.
Pharma CEO Who Said He Only Cares About Shareholders Loses Them Money
Valeant CEO J. Michael Pearson let it be known that his company's shareholders, not patients needing the company's drugs, were his only real concern.
How Correctional Associations Help Corporations Buy Access To Prisons
A new report by In The Public Interest (ITPI) illustrates how private companies that operate prisons or services within prisons use correctional associations to gain intimate access to decision makers in government — almost entirely off the books. Private companies pay millions of dollars each year to attend their conferences, lead trainings and workshops, give speeches, and advertise their products and services to law enforcement officials in attendance.
Anti-Marriage Equality Judge Robert Smith Accused Of Buying Judgeship
Judge Robert S. Smith,who sits on the New York State Court of Appeals, has never been shy about expressing his opinion. At the Federalist Society he proudly identified himself as a Neoliberal saying "I am a Hayekian. I dislike intensely anything that strikes me as unnecessary coercion, whether it's a

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Nelly started the whole "singing rap" thing in the early 2000's and it seems that all of our "MC's" are singing/rapping. Future might have had mastered this style. So who is better with the sing rap? Future or Nelly?
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Millions of businesses rely on cloud technology each day, and recent revelations about PRISM have thrown data security back into the spotlight, demonstrating that where your data is physically located can really matter.
Over the last five years or so more and more companies have started moving business data to the cloud. But while the benefits of the technology are clear, the implications are often not.
In truth, cloud technology can present some real challenges. Not enough companies are giving thought to the legal and physical implications of the cloud. I believe cloud providers have a responsibility to highlight these factors, of which location is one.
It's widely accepted that companies should hold data in a secure facility (usually a building called a data centre, constructed specifically for the purpose). The location of that facility often get overlooked, but it matters.
For starters, some regions are prone to natural events such as earthquakes or floods. Others are beset by political instability and unrest.
The Euro crisis has hit confidence in some European countries which were previously considered rock-solid.
And then there's growing interference by governments - yes, we're back to PRISM again.
In light of these concerns, you're well-advised to investigate the setting of any potential cloud provider's facilities.
When evaluating the location of a cloud provider or hosting firm, these are the main factors to consider:
Not only do you need to keep your data secure, but you also need to maintain a competitive edge.
Cloud services give you extra flexibility and make it easy for you to work on the move, but location plays a part in competitiveness too.
For instance, server response times can vary significantly depending on whether your servers are located relatively nearby (the same country or continent), or further afield (like the other side of the world).
This can have a very real influence on your website's search rankings, because load speed is one of the factors Google takes into account.
These are just some of the reasons your business should pay attention to the location of servers holding your data. Have you give it much thought?
Mateo Meier is founder of Artmotion, which offers hosting services located in Switzerland.
There has been no shortage of analysis of the cloud, and the business benefits it can bring. Unsurprisingly for an emerging technology, there has been a great deal of confusion about what it is and how businesses can use it.
The uptake of cloud computing has even been slow among smaller businesses, which traditionally tend to be quicker to adopt new technologies. One piece of research found only 9% of small and medium-sized businesses were using the cloud at the end of 2011.
I think this is set to change and change dramatically. Our research found that one in four small businesses are transforming the way they work by embracing the cloud. Nearly half of these firms started using online software to run their business in the past 12 months.
The adoption of cloud technology amongst small businesses is really starting to gain momentum – something we have seen with our own cloud software. Reduced spending, more efficient use of time and the ability to stay connected regardless of location are factors that can improve business productivity, performance and - ultimately - stability and growth.
However, although adoption is increasing, confusion still exists. Many of our customers have needed advice about how to move services over into the cloud, and help to understand how it can best benefit their business.
If your business is considering a move to the cloud, here's my layman's guide to what to think about before making the transition:
Nick Goode is head of Sage One, a cloud-based accounts and payroll service from Sage (UK) Limited that requires no formal training and includes FREE 24/7 customer support and advice. Register for a FREE 30 day trial now or visit www.facebook.com/SageOneUK to find out more.
The launch of the long-rumoured Google Drive happened yesterday. But is this online storage a useful new service for businesses, or is it a step too far for a company that already knows so much about you?
If you've ever used Dropbox, SkyDrive, Box, SugarSync or any other cloud-based storage, you'll be familiar with what Google Drive does. It gives you access to online storage, to which you can upload documents, photos, files … any of your data, basically.
You create a special folder on your computer (your 'Google Drive'). Anything placed in this folder gets uploaded to your online storage. Here's why you might do this:
But what's new? All these features are already offered by most of the other online storage services I mentioned above. Is there anything to make Google Drive different?
Perhaps the biggest thing that sets Google Drive apart from its competitors is the fact that it's one of a whole portfolio of services from the ubiquitous search engine. This means Google Drive is closely integrated with elements of the company's other services. For instance:
There's one other thing that makes Google Drive attractive, and that's the price. It's significantly cheaper than most competitors. For instance, it costs $9.99 a month (all the prices are in US dollars, even though I'm in the UK) for 50GB of storage with Dropbox. With Google Drive, twice that costs $4.99.
As with most cloud storage services, there's also a basic free option – Google Drive gives you 5GB free, which is actually enough for loads of documents.
Google Drive is poised to shake up the online storage market. Expect prices of competing services to drop over the next few months, as Google takes a big bite of the market.
It may also be worth considering if your business already uses other Google Services, because Google Drive will work very well with them. If you're using Google Apps for your email and document editing, then Google Drive may be a logical next step.
However, before you jump in with both feet, it's worth just stopping to think through the implications of the service. Google uses detailed information about its users in order to show them targeted advertising. For instance, the adverts you see in Google Mail are determined – to some extent – by the content of your emails.
Google is likely to extend this capability with Google Drive. It might not show you adverts within your Google Drive, but it will almost certainly analyse your data to help it target ads at you when you're signed in to other Google services.
So, are you comfortable granting Google access to your files, some of which may contain important business or personal information? The answer to that will probably depend on your attitude towards the company overall, and your feelings about targeted advertising.
As part of its Google Drive FAQ, CNET has a good summary of how Google says it may use your files. You might also be interested in this succinct argument against the service from Chris Armstrong and Aral Balkan's interesting analogy.
Read Google's official announcement about Google Drive. Will you be signing up to try the service?
Starting up is undoubtedly the hardest part of any business. Finding funding, scoring that all-important first client and managing on meagre cashflow are all difficult but important steps for any new enterprise.
But after a while - assuming you're successful - you'll be established with a stable client base. You might even be turning a profit. What's next? If you're ready for another challenge, it could be time to scale!
In the past, scaling often meant buying costly new equipment, paying a small fortune in software licences and employing a dedicated IT staff to manage it all. Nowadays, with modern cloud computing becoming more widespread, many of those costs have been eliminated. This means scaling your business - although still not without risk - is significantly more achievable.
Google Apps, for example, can take the place of your traditional Microsoft Office desktop suite, offering web-based email, calendar and productivity tools. Best of all, Google Apps is completely free for companies with up to ten employees.
Cloud software can pay dividends in other ways too. Without hefty applications weighing down your office computers (all you need is a web browser) you can do without expensive top-of-the-line computers. And because maintenance is managed by the cloud software provider, you don't need the same level of in-house IT support.
Cloud software is becoming so pervasive that new services are springing up every day to offer a cheap, hassle-free alternative to desktop software. Some of the more successful cloud software services are:
Which cloud computing tools does your business rely on? Have they made it easier for your company to grow?
Darren Fell is MD at Crunch.
Was 2011 the year of cloud computing? Whatever your view, there's certainly no denying that it created a lot of hype.
I like to say it was the year when businesses discovered the Cloud. It's during 2012 that we'll see a bigger movement towards it.
Cloud computing has been around for years, but it was only last year that the technology and marketing hit that critical point where businesses could start to fully understand what it is.
This year, 2012, will be the real year of the cloud. This is why:
At SpiderGroup, we are already seeing an increase in cloud popularity. We believe 2012 is, without doubt, the year of the cloud. And we promise not to say the same thing next year.
This guest post was written by Kerry Hale from SpiderGroup.
Photo credit: Camdiluv
Cassette tapes. Floppy disks. CD-ROMs. Is your hard drive heading the same way? Not yet... But you don't have to wait for your hard drive to die to imagine it in storage heaven. Businesses are already looking to the skies to store critical data and run applications, using what's called the cloud.
cloud com·put·ing: working with files and software on the Internet, rather than on your hard drive
Not only does working in the cloud keep your files and apps backed up and on the internet, it allows you to work anywhere. You don't have to be at your desk or even be at a desk at all.
Here are 10 cloud-based apps that can help you work wherever you like:
In summary, it could do to the USB stick what the MP3 did to the MiniDisc.
Because it looks like any other folder on your computer, it can also turn regular apps into cloud apps by hosting files and settings. For example, I use typing shortcut utility TextExpander. I put its settings file in my Dropbox so that my shortcuts sync across my desktop computer at home and my laptop when I'm on the move.
Dropbox Basic is free and includes 2GB of storage; other account types are available.
Evernote is available through your web browser, Windows and Mac desktop apps and mobile apps for iPhone, Android, Windows Phone 7, BlackBerry and Web OS.
Evernote is free; Evernote Premium is $5 per month or $45 per year.
You can upload files from your desktop to get started, access documents from connected computers and smart phones and collaborate in real-time with colleagues.
Google Docs is free.
Google's solution is a good one, and it'll sync with your Android phone, of course, and with your BlackBerry, iPhone, Windows and Nokia phone using Google Sync.
Gmail and Google Calendar are free.
HootSuite, on the other hand, runs in your browser, on your smart phone and tablet device, does everything TweetDeck does and more, and it's better looking. Oh, and The White House (@whitehouse) uses it too.
HootSuite Basic is free; HootSuite Pro is $5.99 per month.
Delicious is a bookmarking service that keeps all of your important links in the cloud, so you can get to them from any computer.
Delicious is free.
And then it syncs up so the article is ready to read on its website or offline on your iPhone, iPad or Kindle - perfect for when you do have time to read, like when you're travelling.
Instapaper is free.
Better-looking alternatives include Flow and Wunderlist.
Toodledo is free; Toodledo Pro is $14.95 per year; Toodledo Pro Plus is $29.95 per year.
Salesforce starts at $2 per month and can cost up to $250 per month, depending on what you need.
There's a free version of Basecamp; other plans can cost up to $149 per month, depending what you need.
All prices shown are in US dollars - you'll pay the equivalent in pounds charged by your credit card issuer.
San Sharma (@WorkSnugSan) is Community Manager at WorkSnug (@WorkSnug), a free mobile app and website that helps you find laptop-friendly workspaces, like coffee shops with Wi-Fi.
Can cloud computing reduce carbon emissions? (Image: Aske Holst on Flickr.)
More businesses than ever are moving some of their IT to the cloud. In fact Microsoft's SMB Cloud Adoption Study 2011, which surveyed more than 3,000 businesses worldwide, showed that 39% expect to use at least one cloud computing service by 2013.
As concerns over global warming increase, cloud computing is being hailed as green computing too. But can this really be true? Is the cloud the easiest way to move to green computing?
Green computing is computing which uses electricity efficiently.
According to a 2001 study (PDF link), an office of 10 typical PCs, storing data locally and saving documents on a server, consumes an average of 215 kWh of electricity per working week. Those PCs also produce a lot of heat, which may mean you need air-conditioning, using even more power.
In its most extreme form, cloud computing replaces your business PCs with 'thin clients' which contain no software, no disk and no moving parts. They connect to a remote server which stores data and does the actual work. Everything you need, you access remotely.
This can significantly cut the amount of energy you use in your office. On average, the same size office would consume 133 kWh per working week. That's a big difference: in terms of carbon emissions, it's like driving 9.000 fewer miles in a new car. Even allowing for improvements in PC efficiency since that 2001 study, you're still likely to see a saving.
So it might mean you have green computing on your premises. But are you just shifting the environmental impact elsewhere?
Some environmental organisations have questioned how green the cloud really is. After all, cloud computing requires lots of servers, kept in vast datacentres which consume huge amounts of power.
Greenpeace has been particularly vocal in dampening the cloud's green computing credentials. Their supporting report suggests IT energy consumption will triple by 2020. But could this just be down to the growing use of technology rather than the cloud?
After all, the use of home computers has been on the rise for years and 35% of homes now have more than just one computer.
The Greenpeace report does recognise that IT companies look to locate their datacentres in places that minimise the environmental impact. For instance, HP put a datacentre in Newcastle because then they could use the sea air to cool servers naturally. And Yahoo uses hydroelectric power in its New York datacentre.
The environmental performance of cloud computing really depends on how you use it and which equipment you choose.
Older computers were not built to be environmentally friendly, so if you're simply hooking a cloud computing service up to a five-year-old PC then you're not doing a lot to move to green computing.
In contrast, combining the cloud with a modern, more energy efficient computer can almost certainly reduce the amount of energy your IT uses.
Check out the Google Chromebook. Almost nothing is stored on this laptop. All you have is a web browser, through which you have to do everything. This is perhaps green computing in its purest form, showing how cloud computing can help to create a greener technological future.
At SpiderGroup, we say cloud computing is green computing, and as it seems the cloud is here to stay, we think it can only get greener.
Does green computing matter to your business? Do you even care about being environmentally friendly? Let us know by leaving a comment.
This guest post was written by Kerry Hale from SpiderGroup.


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I've begun development on a isometric game, and have what I thought to be the hard part out of the way - the map generation from external files, screen-to-isometric conversions, etc. However I'm getting stumped on the "easy" stuff.
Basically what I'm trying to do is this. Create a function that will add an object to the map (stage), then add an eventlistener so when it's clicked on, it gets added to the player's inventory. Lets take this sample code:
In the 'onObjectClick' function, I'm trying to figure out how to add the object that's being clicked on to an array variable declared in the Main class. I had something like 'event.target.name', but that only gives me a string value of the object. I want to add the actual object to the 'playerInventory' array, so I can use them later on.Code:public function addObjectToWorld(o:IsoObject):void { // ...code to add it to the world this.addEventListener(MouseEvent.CLICK, onObjectClick); } public function onObjectClick(e:MouseEvent):void { // this is where I'm having a problem.... }
As a side note, all the objects that could be clicked on will be classes that extend 'IsoObject', so I was trying to use Polymorphism in my code (ie. all the 'playerInventory' objects were IsoObjects, so they could accept all the items such as ball(), pipe(), etc.), but it wasn't helping me come to an answer.
Any ideas?


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Shovelling manure
Credit: Jill Ferry Photography
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Licence type: Royalty-freeRoyalty-free pricing is based solely on the size of the product you need, not the specific use. You don't have to pay any additional royalties on a use-by-use basis. Once you license a royalty-free product, you may use it multiple times for multiple projects without paying additional fees. (Pornographic, defamatory, libellous or otherwise unlawful use of any image is, of course, prohibited.)
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Shovelling Manure Stock Photo4x4,55-59 Years,Adult,Adults Only,Bending,Billboard,Casual Clothing,Caucasian Appearance,Colour Image,Communication,Day,Digging,Dung,Focus On Foreground,Full Length,Grey Hair,Holding,Horizontal,Mature Adult,New Zealand,One Man Only,One Mature Man Only,One Person,Only Men,Organic,Outdoors,People,Photography,Plant,Preparation,Shorts,Spade,Standing,T-Shirt,Wellington Boot,Western Script,White Hair,WorkingPhotographer Jill Ferry PhotographyCollection: Moment Open ©Jill Ferry 2013a man shovelling horse manure into a trailer so he can use it in his organic garden.


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Review: 'The Americans' - 'Covert War'
A review of tonight's "The Americans" coming up just as soon as I make insurance...
A review of tonight's "The Americans" coming up just as soon as I make insurance...
A review of the two-part "Suburgatory" season finale coming up just as soon as my troubles melt away like so much provolone...
The final 8 episodes of "Breaking Bad" will debut on Sunday, August 11 at 9 p.m., one of many announcements made today at AMC's upfront presentation for advertisers.
Tomorrow night, NBC is airing back-to-back episodes of "Parks and Recreation" at 9 and 9:30 ("The Office" gets the week off), and they're two of my favorite installments of the season. And yet the funniest part of either one isn't going to air at all.
In the first episode, titled "Article Two," Patton Oswalt guest stars as another Pawnee crackpot who gets upset at Leslie's proposal to eliminate some of the more outdated/racist/sexist laws on the town charter. Taking advantage of the laws still on the books, he launches into a citizen filibuster discussing his proposal for the J.J. Abrams-directed "Star Wars" sequel, which somehow turns into a "Star Wars"/Marvel Comics mash-up halfway through.
In the episode itself, you hear a few lines of dialogue from it, but when the episode was filmed, "Parks" producer Dan Goor told Oswalt to just improvise something and they would edit it down as needed in the final cut. Oswald launched into an eight-minute rant that you can watch below. It's remarkable for the absolutely hardcore nerditry of it, for Oswalt's commitment to a bit that he knew would likely never air, and also for veteran improv comic Amy Poehler's gift for interrupting at just the right moments and with just the right observations. It's really remarkable. Enjoy, and I look forward to discussing both "Article Two" and "Jerry's Scrapbook" with you after they air tomorrow night.
As Netflix pushes into the world of original programming, it's easy to see why the streaming video giant picked up certain series. "House of Cards" had a two-time Oscar winner as its star, David Fincher as an executive producer and a look and feel that automatically put Netflix into the discussion with HBO, AMC, etc. "Arrested Development" (which will debut on Netflix in May) is a show that, while never a hit on FOX, was beloved then and has been among the most popular titles in Netflix's library.
With "Hemlock Grove," whose 13-episode first season will be released in its entirety on Netflix on Friday, you have to squint a bit to see why it was chosen. Yes, it's a supernatural thriller larded with teen angst, which has value in the age of "Twilight" and "The Vampire Diaries." And it has a movie pedigree as well: Eli Roth is an executive producer and directed the pilot, and the cast includes Famke Janssen and Dougray Scott.
But it's also a mess: a horror series with a weirdly slow build (you don't even see the lead werewolf character transform until the end of the second episode), a mix of campy performances and competent ones, and just enough intriguing ideas to make me wish the entire thing was a lot better than it is.
A quick review of last night's "How I Met Your Mother" coming up just as soon as my life turns into an angsty, existential Italian black-and-white movie...
Sundance just concluded its airing of "Top of the Lake," which I reviewed back in March. Now that it's all over, I have some spoiler-iffic thoughts on how everything resolved, coming up just as soon as there is no match for the tremendous intelligence of the body...
In what we believe is our longest Firewall & Iceberg Podcast episode ever, Dan and I got busy with a mix of premieres (Syfy's "Defiance," Netflix's "Hemlock Grove"), looks back (last night's "Mad Men" plus the "Cougar Town" and "Go On" finales), mail, plus an overdue retrospective on the career and influence of the late, great Roger Ebert.
Please note: We recorded this earlier today, and were literally saying our goodbyes when I first saw news of the tragedy in Boston. Our usual banter reflects that ignorance. If you're not in the mood to hear us bicker right now, we understand.
The lineup:
And as always, feel free to e-mail us questions for the podcast.
When I wrote last week about the improbable problem of too much good TV, several of you noted that the problem is compounded by just how much of it gets concentrated on Sunday nights between 9 and 11. That's the night that HBO made its signature, and Showtime, AMC and others have followed. The new era of On Demand, streaming and multiple plays throughout the week makes this less of an issue for some, but if you like to talk about your favorite shows the day after they air — and if a lot of them air on the same night at the same time — it gets tricky.
AMC has already tried expanding beyond Sundays by moving its reality TV bloc to Thursday nights(*), and today the channel announced its first scripted move away from Sundays in quite some time, as the third season of "Hell on Wheels" will air on Saturday nights at 9, starting August 3.
(*) Which once upon a time was the home of "Mad Men," before AMC executives decided to move in on HBO's turf starting with the second season.
A review of tonight's "Mad Men" coming up just as soon as I have your wig ready, ma'am...


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Sweet 17.5 h 12 year old Oldenburg/Thoroughbred cross. Great on trails, jumping, hunting, or pleasure horse. Gentle enough to be ridden by beginner but…$3,200
Fadila is a lovely filly. Dam evented through Prelim, 1/2 sister to a 3* winner and top 5 at 4*. Sire is Flint GSF, by Welstern. Lovely mover. While bred…SOLD
Do you need a handsome, push button, packer to take your nervous, timid, or learning or a rider just wanting a fun, made, fancy horse to have at the shows…SOLD
Rheanna has competed up to 3'6" in jumpers with a pro and a junior. Bold and careful jumper. Nice mover. Good to hack out. No vices, easy keeper, doesn…SOLD
PF Katydid - Attractive, blood bay, 16.0 hand, 6 year old, big bodied, Oldenburg/TB cross mare by Chancellor (by Voltaire). "Katy" is a pretty mover, with…SOLD
Logan - Very handsome, 17.0 hand, 9 year old, dark bay, Old/TB gelding. "Logan" is in his third season foxhunting both first field and in the hilltoppers…SOLD
A dream pedigree wrapped in a handy package, Eireheart is a talented gelding by the versatile Hanoverian licensing champion Escudo II (Espri x Arkansas…SOLD
Branded Oldenburg mare (Royal Appearance X Valdiva) Scored an over all 8.2 and has a premium filly classification. 3yrs old, 15.2h and still growing. Has…SOLD


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Since 1832, when Henry Newton and William Winsor introduced the first moist watercolors to the world, much of Winsor & Newton's reputation for supreme quality has stemmed from its Professional Watercolor range. More than 180 years later, the original Winsor & Newton moist watercolor continues to be formulated and manufactured according to the company's founding principles — to create an unparalleled watercolor range that offers professional artists the widest and most balanced choice of pigments with the greatest possible permanence.
Through strict adherence to these founding principles, Winsor & Newton Professional Watercolors offer brilliance, transparency, and purity of color unparalleled by any other brand. For the 21st century, these key qualities are achieved through a combination of choice of raw materials, custom-made machinery, and expert formulation by experienced chemists and artists.
Today, the Winsor & Newton Professional Watercolor range benefits from continued advancements in pigment technology and production methods, building on the company's already high standards to produce even brighter, more transparent, and more stable colors. Equally important, many of the formulations remain the same — proving that they cannot be bettered!
Lightweight Sketchers' Box Set of 12 Tubes
Designed to travel, this set's lightweight tube box is made of black enameled metal. It holds 12 watercolor tubes, and has four large wells and 10 smaller wells. The set contains one 5 ml tube each of Permanent Alizarin Crimson, Burnt Sienna, Burnt Umber, Raw Umber, Lamp Black, Cobalt Blue, Winsor Lemon, Viridian, Winsor Blue (Green Shade), Scarlet Lake, Winsor Yellow, and Yellow Ochre. Colors in the set may vary.
Limited Edition Colors
Hurry to experience these exciting, limited edition colors before supplies run out. The six colors include Dark Brown, Gold Brown, Indian Red Deep, Phthalo Sapphire, Transparent Orange, and Yellow Titanate.
Color Chart Note — Use this color chart as an approximation of the real color. If exact color matching is necessary, use actual samples of the materials.
Pricing Note — Items with the Blick Best Price icon () on this page are not eligible for additional discounts due to pricing restrictions set by the manufacturer.
Shipping Note — Due to manufacturer distribution restrictions, Winsor & Newton products cannot be shipped to addresses outside of North America.
5 ml
.17 oz
14 ml
.47 oz
37 ml
1.25 oz
Winsor & Newton recommends the following colors for its basic palette: Winsor Lemon, Winsor Yellow, Scarlet Lake, Permanent Rose, Permanent Alizarin Crimson, French Ultramarine, Winsor Blue (Green Shade), Winsor Green (Blue Shade), Raw Umber, Yellow Ochre, Burnt Sienna, and Chinese White.
Single pigment secondary colors help you create brighter mixes than are possible by mixing colors from Winsor & Newton's basic palette: Winsor Orange, Quinacridone Magenta, Permanent Magenta, Thioindigo Violet, Cobalt Violet, Permanent Mauve, Ultramarine Violet, Winsor Violet (Dioxazine), Cobalt Turquoises and Greens, Viridian, Winsor Greens, Oxide of Chromium, Green Gold.
Winsor & Newton recommends the following colors for landscape painting: Nickel Titanium Yellow, Transparent Yellow, Cadmium Yellow Pale, Indanthrene Blue, Cobalt Blues, Winsor Blue (Red Shade), Prussian Blue, Cerulean Blue, Manganese Blue Hue, Cobalt Turquoises, Cobalt Greens, Viridian, Winsor Green (Yellow Shade), Terre Verte, Oxide of Chromium, Hooker's Green, Permanent Sap Green, Olive Green, Green Gold, Naples Yellow Deep, Raw Sienna, Light Red, Caput Mortuum Violet, Burnt Umber, Payne's Gray, Davy's Gray, Ivory Black, and Titanium White.
Winsor & Newton recommends the following colors for portraiture: Lemon Yellow (Nickel Titanate), Nickel Titanium Yellow, Cadmium Yellow Pale, Cadmium Orange, Cadmium Scarlet, Cadmium Red Deep, Rose Dor, Quinacridone Red, Permanent Carmine, Rose Madder Genuine, Purple Madder, Permanent Magenta, Cobalt Violet, Permanent Mauve, Cobalt Blue, Cerulean Blue, Cobalt Turquoise, Naples Yellow, Naples Yellow Deep, Raw Sienna, Light Red, Venetian Red, Indian Red, Caput Mortuum Violet, Burnt Umber, Davy's Gray, Ivory Black, and Titanium White.
The following colors are more transparent: Aureolin, Gamboge Genuine, Indian Yellow, Rose Dor, Quinacridone Red, Permanent Alizarin Crimson, Permanent Carmine, Rose Madder Genuine, Quinacridone Magenta, Purple Madder, Permanent Magenta, Thioindigo Violet, Winsor Violet (Dioxazine), Ultramarine (Green Shade), Winsor Blue (Red Shade), Antwerp Blue, Prussian Blue, Viridian, Winsor Green (Yellow Shade), Hooker's Green, Permanent Sap Green, Olive Green, Green Gold, Raw Sienna, Quinacridone Gold, Perylene Maroon, and Burnt Umber. Gum Arabic increases the transparency of Artists' Watercolors.
The following colors are more opaque: Lemon Yellow (Nickel Titanate), Cadmium Yellows, Orange and Reds, Winsor Emerald, Oxide of Chromium, Cobalt Green (Yellow Shade), Naples Yellow, Naples Yellow Deep, Light Red, Venetian Red, Indian Red, Caput Mortuum Violet, Sepia, Indigo, Neutral Tint, Blue Black, Ivory Black, Lamp Black, and Titanium White.
The following colors have the highest tinting strength: Bismuth Yellow, Cadmium Yellows, Orange and Reds, Quinacridone Reds and Violets, Winsor Violet (Dioxazine), Indanthrene Blue, Winsor colours, Titanium White.
The following colors have the lowest tinting strength and produce more subdued color: Antwerp Blue, Cerulean Blue, Cobalt Turquoise, Cobalt Green, Viridian, Terre Verte, Oxide of Chromium, Naples Yellow, Naples Yellow Deep, Raw Sienna, Light Red, Indian Red, Caput Mortuum Violet, Burnt Umber, Vandyke Brown, Sepia, Indigo, Payne's Gray, Blacks, Davy's Gray.
see also ...
™ Winsor & Newton is a trademark.
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Formerly known as Winsor & Newton Artists' Watercolors, Winsor & Newton Professional Watercolors have a new name and new look, but their reliable quality remains unchanged.
During the transition in stock, you may receive a combination of new tubes and old tubes. Rest assured, they both contain the same outstanding formulations you've come to know and trust.
Hint — click a thumbnail to enlarge.
(based on 341 reviews)
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Excellent product when working within a budget!
By Dianne
from Bennington, Vermont
Comments about Winsor & Newton Artists' Watercolor Tubes:
As I started painting with student grade Windsor and Newton watercolors,I quickly realized that I couldn't get the results I was seeking.(They are a high quality student grade) I then decided to add a few of the professional grade Windsor and Newton to my palette. The colors are more rich and vibrant and mix well with the student grade colors. I'm very happy with the results. I hope to gradually add more colors and phase out the student grade paints. Windsor and Newton Professional Watercolors are budget friendly. I would recommend this product.
Bottom Line Yes, I would recommend this to a friend
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Really nice colors!
By Sue
from Greenfield, MA
I am a rank beginner using watercolors so while my assessment may not hold much weight with the experienced artist, what I can say unequivocably is that I am having fun and that the colors are superb. I laugh at some of the names, it's like learning a new language. So I guess that means I'm exercising the left and right sides of my brain simultaneously as I explore the uses of these teeny tiny tubes of color explosion. Wow that's a lot of bang for my buck!
Great product, great service
By Pepe First
from Atlanta, GA
great stuff
By frenchladybug
from Austin, TX
Best price
(0 of 1 customers found this review helpful)
Why not use the best?
By Pen
from Salem, Oregon
I really like W&N watercolor. I must admit I'm not a painter - except in a very small way - as I am a calligrapher. But W&N watercolor works very well for me. And I must admit I'm prejudiced as I qm English and have toured the factory where the colors are made. It was a very enjoyable experience - my husband and I wrote and suggested a date; we had a extremely interesting tour, followed by tea! I can recommend the experience.
Consistently good
By Day Lily
from Thousand Oaks
Purchased the mauve and Winsor yellow to add to my collection. The mauve is also known as mineral violet. It's less saturated than dioxazine violet so it's a lot easier to manage. It's also warmer so between these two convenience purples, I'm covered as far as cool, warm, intense and moderate options. The Winsor yellow is my cool yellow. It's not as green as a lemon yellow. I only use Winsor and Newton so can't compare to other brands. I like the 5ml tube option as a way of getting to know a color before committing to larger more economical sizes.
does what it claims
By Dory
from Southwest Florida
I am going back to watercolors after a hiatus, and find this paint is good for its price.
(1 of 1 customers found this review helpful)
Spectacular! Excellent product!
By mj
from Denver
Comments about Winsor & Newton Artists' Watercolor Sets:
the colors are very rich and vibrant. the most solid watercolors i've ever used, and the metal travel tin is fantastic.
My favorite watercolors
By phishnet1
from San Marcos, CA
I bought W&N colors at the suggestion of an artist whose workshop I was taking and have enjoyed the color range and the ease of getting washes that I like. I'm just sorry that I can't buy every single color all at once!
Bought more luminous type water colors and love them.
By Ruhtie
from Hutchinson, Ks
Watercolor class recommended using the 1pigment color for more luminous watercolor mixing.
There IS a difference between Winsor & Newton Artists' Watercolor tubes and pans. Both are professional quality, highly pigmented paint — so what is the difference? Watch this video to learn which paint is best suited for your needs.
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Gigantism and Acromegaly
- Author: Alicia Diaz-Thomas, MD, MPH; Chief Editor: Stephen Kemp, MD, PhD more...
Practice Essentials
Gigantism refers to abnormally high linear growth (see the image below) due to excessive action of insulinlike growth factor I (IGF-I) while the epiphyseal growth plates are open during childhood. Acromegaly is the same disorder of IGF-I excess but occurs after the growth plate cartilage fuses in adulthood.
In acromegaly, a severe disease that is often diagnosed late, morbidity and mortality rates are high, particularly as a result of associated cardiovascular, cerebrovascular, and respiratory disorders and malignancies.[1]
Essential update: Researchers identify new gene that may play a part in growth disorders
Researchers have identified a gene on the X chromosome, GPR101, which was overexpressed 1000-fold more than normal in a genetic study of 43 patients affected by sporadic or inherited gigantism that manifested during childhood or adolescence. This duplication was not evident in patients who began abnormal growth at age 9 or 10, but only in those who started to grow excessively before the age of 3. In a separate analysis of 248 patients with sporadic acromegaly, a mutation in the GPR101 gene was found in about 4% of cases.[2, 3]
The GPR101 gene may be a target for the treatment of growth disorders.
Signs and symptoms
The presentation of patients with gigantism is usually dramatic, unlike the insidious onset of acromegaly in adults. Manifestations include the following:
Tall stature
Mild to moderate obesity (common)
Macrocephaly (may precede linear growth)
Visual changes
Soft tissue hypertrophy
Exaggerated growth of the hands and feet, with thick fingers and toes
Coarse facial features
Frontal bossing
Osteoarthritis (a late feature of IGF-I excess)
Peripheral neuropathies (eg, carpel tunnel syndrome)
Cardiovascular disease
Benign tumors
Signs and symptoms of acromegaly include the following:
Doughy-feeling skin over the face and extremities
Thick and hard nails
Deepening of creases on the forehead and nasolabial folds
Noticeably large pores
Thick and edematous eyelids
Enlargement of the lower lip and nose (the nose takes on a triangular configuration)
Wide spacing of the teeth and prognathism
Cutis verticis gyrata (ie, furrows resembling gyri of the scalp) [4]
Small sessile and pedunculated fibromas (ie, skin tags)
Oily skin (acne is not common)
Hyperpigmentation (40% of patients)
Acanthosis nigricans (a small percentage of patients)
Excessive eccrine and apocrine sweating
Breast tissue becoming atrophic; galactorrhea
High blood pressure
Mitral valvular regurgitation
Mild hirsutism (in women)
Laboratory studies used in the diagnosis of growth hormone (GH)/IGF-I excess include the following:
Oral glucose: To determine the extent to which the patient can suppress GH concentration after the consumption of oral glucose
GH: Clearly elevated GH levels (>10 ng/mL) after oral glucose, combined with the clinical picture, secure the diagnosis of acromegaly
IGF-I: Elevated IGF-I values in a patient whose symptoms prompt appropriate clinical suspicion almost always indicate GH excess
Imaging studies include the following:
Magnetic resonance imaging (MRI): To image pituitary adenomas
Computed tomography (CT) scanning: To evaluate the patient for pancreatic, adrenal, and ovarian tumors secreting GH/GHRH; use chest CT scans to evaluate for bronchogenic carcinoma secreting GH/GHRH
Radiography: To demonstrate skeletal manifestations of GH/IGF-I excess
No single treatment modality consistently achieves control of GH excess. For pituitary adenomas, transsphenoidal surgery is usually considered the first line of treatment, followed by medical therapy for residual disease.[5] Radiation treatment usually is reserved for recalcitrant cases.
Somatostatin and dopamine analogues and GH receptor antagonists are the mainstays of medical treatment for GH excess and are generally used when primary surgery fails to induce complete remission.
Primary treatment with the somatostatin analogues depot octreotide and lanreotide has been found to induce tumor shrinkage in newly diagnosed acromegaly.[6] Dopamine-receptor agonists are generally used as adjuvant medical treatments for GH excess, and their effectiveness may be added to that of octreotide.
Radiation therapy is also generally recommended if GH hypersecretion is not normalized with surgery.
Gigantism refers to abnormally high linear growth due to excessive action of insulinlike growth factor I (IGF-I) while the epiphyseal growth plates are open during childhood. Acromegaly is the same disorder of IGF-I excess but occurs after the growth plate cartilage fuses in adulthood. (See Pathophysiology and Etiology.)
Gigantism is a nonspecific term that refers to any standing height more than 2 standard deviations above the mean for the person's sex, age, and Tanner stage (ie, height Z score >+2). These disorders are placed along a spectrum of IGF-I hypersecretion, wherein the developmental stage when such excess originates determines the principal manifestations. The onset of IGF-I hypersecretion in childhood or late adolescence results in tall stature (see the image below). (See Clinical Presentation and Workup.)
Scientific breakthroughs in the molecular, genetic, and hormonal basis of growth hormone (GH) excess have provided important insights into the pathogenesis, prognosis, and treatment of this exceedingly rare disease. (See Prognosis, Treatment, and Medication.)
Acromegaly is a rare, insidious, and potentially life-threatening condition for which there is good, albeit incomplete, treatment that can give the patient additional years of high-quality life. (See Prognosis, Treatment, and Medication.)[7]
Symptoms develop insidiously, taking from years to decades to become apparent. The mean duration from symptom onset to diagnosis is 5-15 years, with a mean delay of 8.7 years. Excess GH produces a myriad of signs and symptoms and significantly increases morbidity and mortality rates. Additionally, the mass effect of the pituitary tumor itself can cause symptoms. Annual new patient incidence is estimated to be 3-4 cases per million population per year. The mean age at diagnosis is 40 years in males and 45 years in females. (See Presentation.)
Growth hormone and insulinlike growth factor
GH is necessary for normal linear growth. Its secretion from the pituitary gland is controlled by combined hypothalamic regulation, with secretion being stimulated by GHRH and inhibited by somatostatin (also called GH release–inhibiting hormone). Several tissues, including the endocrine pancreas, produce somatostatin in response to GH. (See Pathophysiology and Etiology.)
GH acts indirectly, by stimulating the formation of IGF hormones (also called somatomedins). IGF-I (somatomedin C), the most important IGF in postnatal growth, is produced in the liver, chondrocytes, kidneys, muscles, pituitary gland, and gastrointestinal tract.
Once released into the circulation, GH stimulates the production of IGF-I. The main source of circulating IGF-I is the liver, though it is produced in many other tissues. IGF-I is the primary mediator of the growth-promoting effects of GH.
It is characterized by increased and unregulated GH production, usually caused by a GH-secreting pituitary tumor (somatotroph tumor). Other causes of increased and unregulated GH production, all very rare, include increased GH-releasing hormone (GHRH) from hypothalamic tumors; ectopic GHRH from nonendocrine tumors; and ectopic GH secretion by nonendocrine tumors.
Pathophysiology and Etiology
Causes of excess IGF-I action can be divided into the following 3 categories:
Release of primary GH excess from the pituitary
Increased GHRH secretion or hypothalamic dysregulation
Hypothetically, the excessive production of IGF-binding protein, which prolongs the half-life of circulating IGF-I
By far, most people with gigantism or acromegaly have GH-secreting pituitary adenomas or hyperplasia. Other causes of increased and unregulated GH production, all very rare, include increased GHRH from hypothalamic tumors; ectopic GHRH from nonendocrine tumors; and ectopic GH secretion by nonendocrine tumors.
Although gigantism is typically an isolated disorder, rare cases occur as a feature of other conditions, such as the following:
Approximately 20% of patients with gigantism have McCune-Albright syndrome (the triad of precocious puberty, café au lait spots, fibrous dysplasia) and may have either pituitary hyperplasia or adenomas. (See the image below.)
More than 95% of acromegaly cases are caused by a pituitary adenoma that secretes excess amounts of GH. Histopathologically, tumors include acidophil adenomas, densely granulated GH adenomas, sparsely granulated GH adenomas, somatomammotropic adenomas, and plurihormonal adenomas.
Ectopic production of GH and GHRH by malignant tumors accounts for other causes of IGF-I excess. (Ectopic GHRH-producing tumors, usually seen in the lung or pancreas, may occasionally be evident elsewhere, such as in the duodenum as a neuroendocrine carcinoma.)[8, 9]
Of these tumors, up to 40% have a mutation involving the alpha subunit of the stimulatory guanosine triphosphate (GTP)–binding protein. In the presence of a mutation, persistent elevation of cyclic adenosine monophosphate (cAMP) in the somatotrophs results in excessive GH secretion.
The pathologic effects of GH excess include acral overgrowth, insulin antagonism, nitrogen retention, increased risk of colon polyps/tumors, and acral overgrowth (ie, macrognathia; enlargement of the facial bone structure, as well as of the hands and feet; and visceral overgrowth, including macroglossia and enlargement of the heart muscle, thyroid, liver, and kidney).[10]
Pathologic studies on acromegalic hearts have shown extensive interstitial fibrosis, suggesting the existence of a specific acromegalic cardiomyopathy.
GH/IGF-I excess
Despite diverse pathophysiologic mechanisms, the final common abnormality in gigantism and acromegaly is IGF-I excess. Elevated tissue levels of free IGF-I, which is produced primarily in hepatocytes in response to excess GH, mediate most, if not all, growth-related outcomes in gigantism. Transgenic mice that overexpressed GH, GHRH, or IGF-I were found to have dramatically accelerated somatic growth compared with control litter mates.
One acromegalic patient had low serum GH levels and elevated serum total IGF-I levels; this finding implicates IGF-I as the key pathologic factor in this disease. Serum levels of IGF-I are consistently elevated in patients with acromegaly and, therefore, are used to monitor treatment success. The conditions described below can cause IGF-I oversecretion.
Primary pituitary GH excess
In most individuals with GH excess, the underlying anomaly is a benign pituitary tumor composed of somatotrophs (GH-secreting cells) or mammosomatotrophs (GH-secreting and prolactin-secreting cells) in the form of a pituitary microadenoma (< 1 cm) or macroadenoma (>1 cm). The adenomas are most characteristically well-demarcated and confined to the anterior lobe of the pituitary gland. In some people with GH excess, the tumor spreads outside the sella, invading the sphenoid bone, optic nerves, and brain. GH-secreting tumors are more likely to be locally invasive or aggressive in pediatric patients than in adults.
Gs-alpha (Gsa) mutation
G proteins play an integral role in postligand signal transduction in many endocrine cells by stimulating adenyl cyclase, resulting in an accumulation of cyclic adenosine monophosphate (cAMP) and subsequent gene transcription. About 20% of patients with gigantism have McCune-Albright syndrome and pituitary hyperplasia or adenomas.
Activating mutations of the stimulatory Gsa protein have been found in the pituitary lesions in McCune-Albright syndrome and are believed to cause the other glandular adenomas observed. Point mutations found in several tissues affected in McCune-Albright syndrome involve a single amino-acid substitution in codon 201 (exon 8) or 227 (exon 9) of the gene for Gsa. Somatic point mutations have been identified in the somatotrophs of less than 40% of sporadic GH-secreting pituitary adenomas. The resulting oncogene (gsp) is thought to induce tumorigenesis by persistently activating adenyl cyclase, with subsequent GH hypersecretion.
Loss of band 11q13 heterozygosity
Loss of heterozygosity at the site of a putative tumor-suppressor gene on band 11q13 was first identified in tumors from patients with MEN type I and GH excess. Loss of heterozygosity at band 11q13 has also been observed in all types of sporadically occurring pituitary adenomas. It is associated with an increased propensity for tumoral invasiveness and biologic activity.
Isolated familial somatotropinoma, a rare disease, refers to the occurrence of 2 or more cases of acromegaly or gigantism in a family in whom the features of Carney complex or MEN type 1 are absent.[11] It appears to be inherited as an autosomal dominant disease with incomplete penetrance. Although an association exists between isolated familial somatotropinoma and loss of heterozygosity on 11q13, the responsible gene remains unknown.
Abnormality at Carney loci on chromosomes 2 and 17
The Carney complex, which is characterized by myxomas, endocrine tumors, and spotty pigmentation, is transmitted as an autosomal dominant trait. About 8% of affected individuals have GH-producing pituitary adenomas. The causative gene for this disease was mapped to bands 2p16 and 17q22-24. Germline mutations in PRKAR1A (which encodes for the protein kinase A type I-alpha regulatory subunit, an apparent tumor-suppressor gene on chromosome arm 17q) were detected in several families with Carney complex.
Secondary GH excess
Causes of secondary GH excess include increased secretion of GHRH due to an intracranial or ectopic source and dysregulation of the hypothalamic-pituitary-GH axis.
GHRH excess
Hypothalamic GHRH excess is postulated as a cause for gigantism, possibly secondary to an activating mutation in hypothalamic GHRH neurons. Excess GHRH secretion may be due to an intracranial or ectopic tumor. Several well-documented incidents of hypothalamic GHRH excess demonstrated intracranial gangliocytomas associated with gigantism or acromegaly.
Ectopic GHRH-secreting tumors have included carcinoid, pancreatic islet-cell, and bronchial neoplasms. Prolonged tumoral secretion of GHRH leads to pituitary hyperplasia, with or without adenomatous transformation, that increases levels of GH and other adenohypophyseal peptides.
Disruption of somatostatin tone
Tumoral infiltration into somatostatinergic pathways are hypothesized to be the basis for GH excess in rare incidents of gigantism associated with neurofibromatosis and optic glioma or astrocytomas.
Occurrence in the United States
Gigantism is extremely rare, with approximately 100 reported cases to date. Acromegaly is more common than gigantism, with an incidence of 3-4 cases per million people per year and a prevalence of 40-70 cases per million population.
Age-related demographics
Gigantism may begin at any age before epiphyseal fusion. The mean age for onset of acromegaly is in the third decade of life; the delay from the insidious onset of symptoms to diagnosis is 5-15 years, with a mean delay of 8.7 years. The mean age at diagnosis for acromegaly is 40 years in males and 45 years in females.
Because of the small number of people with gigantism, mortality and morbidity rates for this disease during childhood are unknown.
In acromegaly, a severe disease that is often diagnosed late, morbidity and mortality rates are high, particularly as a result of associated cardiovascular, cerebrovascular, and respiratory disorders and malignancies.[1]
Because IGF-I is a general growth factor, somatic hypertrophy in acromegaly occurs across all organ systems. Associated complications include the following[12] :
Acromegalic heart
Increased muscle and soft tissue mass
Increased kidney size
Articular overgrowth of synovial tissue and hypertrophic arthropathy
Joint symptoms, back pain, and kyphosis: Common presenting features
Thick skin
Hyperhidrosis (often malodorous)
Carpal tunnel syndrome and other entrapment syndromes
Macroglossia: May result in sleep apnea
Cerebral aneurysm and increased risk of cerebrovascular accident: Less common [13]
Early diagnosis of acromegaly, however, results in early transsphenoidal pituitary microsurgery, and currently, patients are more likely to be cured than in the past.
Reversal of excessive GH produces the following:
Decreased soft tissue swelling
Diminished sweating
Restoration of normal glucose tolerance
No studies have established, however, that the treatment of acromegaly leads to a reduction in morbidity and mortality rates, although successful treatment, with normalization of IGF-I levels, may be associated with a return to normal life expectancy.
Remission depends on the initial size of the tumor, the patient's GH level, and the skill of the neurosurgeon. Remission rates of 80-85% and 50-65% can be expected for microadenomas and macroadenomas, respectively.
The postoperative GH concentration may predict remission rates. According to the results of one study, a postoperative GH concentration of less than 3 ng/dL was associated with a 90% remission rate, which declined to 5% in patients with a postoperative GH concentration of greater than 5 ng/dL.
Metabolic and endocrine complications
Diabetes mellitus occurs in 10-20% of patients with acromegaly. A 2009 study suggests that in patients with acromegaly, insulin resistance and hyperinsulinemia are positively correlated with the level of disease activity.[14] Hypertriglyceridemia is found in 19-44% of patients. Multinodular goiter also is often present in acromegaly.
Hypopituitarism may develop in patients with acromegaly, as a result of the pituitary mass or as a complication of surgery or radiation therapy. Treat pituitary failure with appropriate hormone-replacement therapy.
Respiratory complications
In acromegaly, respiratory complications occur as follows:
Increased lung capacity: 81% of men and 56% of women
Small airway narrowing: 36% of patients
Upper airway narrowing: 26% of patients
Acute dyspnea and stridor
Sleep apnea: As a significant cause of morbidity, sleep apnea may be both obstructive and central; curing acromegaly does not necessarily correct the disorder
Cardiovascular complications
A study by Berg et al found an increased prevalence of cardiovascular risk factors in patients with acromegaly compared with controls.[1] Cardiovascular complications include the following:
Acromegalic cardiomyopathy (with dysfunction and arrhythmias)
Left ventricular hypertrophy
Increased left ventricular mass
Disorders of calcium and bone metabolism
The following calcium and bone metabolism disorders can be found in acromegaly:
Neuromuscular complications
In acromegaly, these include the following:
Weakness (although with muscular appearance)
Nerve root compression
Spinal stenosis
Carpal tunnel syndrome
Cancer risks
Patients with acromegaly may be at increased risk for colorectal cancer and premalignant adenomatous polyps. Most studies suggest that as many as 30% of patients may have a premalignant colon polyp at diagnosis and that as many as 5% may have a colonic malignancy.[15] In studies, polyps were generally multiple and proximal to the splenic flexure, making them less likely to be discovered during sigmoidoscopy. However, the long-term effect of colonic lesions on morbidity and mortality has not been established.
Patients with acromegaly may also have an increased risk of developing breast and prostate tumors, although no clear evidence supports this; the risk of thyroid cancer is increased in males.[10] However, the prevalence of cancers in patients with acromegaly remains controversial, although patients might be advised to undergo screening colonoscopy and thyroid ultrasonography.[16, 17, 15]
For individuals with acromegaly, the mortality rate is 2-3 times that of the general population, with cardiovascular and respiratory complications being the most frequent causes of death. Transgenic mouse models of acromegaly demonstrate cardiac and vascular hypertrophy but normal function, raising the concern that hypertrophic cardiomyopathy may contribute to the increased mortality.[18]
A study by Bates et al suggested that the extent of a patient's GH excess impacts mortality. The investigators found that acromegaly patients with a GH concentration of greater than 10 ng/mL had double the expected mortality rate, whereas patients with a GH concentration of less than 5 ng/mL approached normal mortality.[19] These results underscore the necessity to reduce GH and IGF-I concentration in patients with acromegaly.
Researchers disagree on whether malignancy is a significant cause of increased mortality in acromegaly. Although benign tumors (including uterine myomas, prostatic hypertrophy, and skin tags) are frequently encountered in acromegaly, documentation for overall prevalence of malignancies in patients with acromegaly remains controversial.
Patient Education
Refer patients to the Hormone Health Foundation for additional information.
For patient education information, the Thyroid & Metabolism Center, as well as, Acromegaly, Acromegaly FAQs, and Understanding Acromegaly Medications.
Berg C, Petersenn S, Lahner H, Herrmann BL, Buchfelder M, Droste M, et al. Cardiovascular risk factors in patients with uncontrolled and long-term acromegaly: comparison with matched data from the general population and the effect of disease control. J Clin Endocrinol Metab. 2010 Aug. 95(8):3648-56. [Medline].
Nainggolan L. Gene Discovery in Giants Could Shed Light on Human Growth. Medscape Medical News. Available at http://www.medscape.com/viewarticle/836216.. Accessed: December 12, 2014.
Trivellin G, Daly AF, Faucz FR, Yuan B, Rostomyan L, Larco DO, et al. Gigantism and acromegaly due to Xq26 microduplications and GPR101 mutation. N Engl J Med. 2014 Dec 18. 371(25):2363-74. [Medline].
Al-Bedaia M, Al-Khenaizan AS. Acromegaly presenting as cutis verticis gyrata. Int J Dermatol. 2008 Feb. 47(2):164. [Medline].
Bush ZM, Vance ML. Management of acromegaly: is there a role for primary medical therapy?. Rev Endocr Metab Disord. 2008 Mar. 9(1):83-94. [Medline].
Colao A, Pivonello R, Auriemma RS, Briganti F, Galdiero M, Tortora F, et al. Predictors of tumor shrinkage after primary therapy with somatostatin analogs in acromegaly: a prospective study in 99 patients. J Clin Endocrinol Metab. 2006 Jun. 91(6):2112-8. [Medline].
Giustina A, Chanson P, Bronstein MD, Klibanski A, Lamberts S, Casanueva FF, et al. A consensus on criteria for cure of acromegaly. J Clin Endocrinol Metab. 2010 Jul. 95(7):3141-8. [Medline].
Colak Ozbey N, Kapran Y, Bozbora A, Erbil Y, Tascioglu C, Asa SL. Ectopic growth hormone-releasing hormone secretion by a neuroendocrine tumor causing acromegaly: long-term follow-up results. Endocr Pathol. 2009 Summer. 20(2):127-32. [Medline].
Khandelwal D, Khadgawat R, Mukund A, Suri A. Acromegaly with no pituitary adenoma and no evidence of ectopic source. Indian J Endocrinol Metab. 2011 Sep. 15 Suppl 3:S250-2. [Medline]. [Full Text].
Uchoa HB, Lima GA, Corrêa LL, Vidal AP, Cavallieri SA, Vaisman M, et al. Prevalence of thyroid diseases in patients with acromegaly: experience of a Brazilian center. Arq Bras Endocrinol Metabol. 2013 Dec. 57(9):685-90. [Medline].
Soares BS, Eguchi K, Frohman LA. Tumor deletion mapping on chromosome 11q13 in eight families with isolated familial somatotropinoma and in 15 sporadic somatotropinomas. J Clin Endocrinol Metab. 2005 Dec. 90(12):6580-7. [Medline].
Melmed S, Casanueva FF, Klibanski A, Bronstein MD, Chanson P, Lamberts SW, et al. A consensus on the diagnosis and treatment of acromegaly complications. Pituitary. 2013 Sep. 16(3):294-302. [Medline]. [Full Text].
Oshino S, Nishino A, Suzuki T, et al. Prevalence of cerebral aneurysm in patients with acromegaly. Pituitary. 2013 Jun. 16(2):195-201. [Medline].
Stelmachowska-Banas M, Zdunowski P, Zgliczynski W. Abnormalities in glucose homeostasis in acromegaly. Does the prevalence of glucose intolerance depend on the level of activity of the disease and the duration of the symptoms?. Endokrynol Pol. 2009 Jan-Feb. 60(1):20-4. [Medline].
Dworakowska D, Gueorguiev M, Kelly P, Monson JP, Besser GM, Chew SL, et al. Repeated colonoscopic screening of patients with acromegaly: 15-year experience identifies those at risk of new colonic neoplasia and allows for effective screening guidelines. Eur J Endocrinol. 2010 Jul. 163(1):21-8. [Medline].
Loeper S, Ezzat S. Acromegaly: re-thinking the cancer risk. Rev Endocr Metab Disord. 2008 Mar. 9(1):41-58. [Medline].
Kurimoto M, Fukuda I, Hizuka N, Takano K. The prevalence of benign and malignant tumors in patients with acromegaly at a single institute. Endocr J. 2008 Mar. 55(1):67-71. [Medline].
Izzard AS, Emerson M, Prehar S, Neyses L, Trainer P, List EO, et al. The cardiovascular phenotype of a mouse model of acromegaly. Growth Horm IGF Res. 2009 Oct. 19(5):413-9. [Medline].
[Guideline] Katznelson L, Atkinson JL, Cook DM, Ezzat SZ, Hamrahian AH, Miller KK. American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the Diagnosis and Treatment of Acromegaly--2011 update: executive summary. Endocr Pract. 2011 Jul-Aug. 17(4):636-46. [Medline].
Wang M, Mou C, Jiang M, Han L, Fan S, Huan C, et al. The characteristics of acromegalic patients with hyperprolactinemia and the differences in patients with merely GH-secreting adenomas: clinical analysis of 279 cases. Eur J Endocrinol. 2012 May. 166(5):797-802. [Medline].
Almalki MH, Chesover AD, Johnson MD, Wilkins GE, Maguire JA, Ur E. Characterization of management and outcomes of patients with acromegaly in Vancouver over 30 years. Clin Invest Med. 2012 Feb 1. 35(1):E27-33. [Medline].
Sata A, Ho KK. Growth hormone measurements in the diagnosis and monitoring of acromegaly. Pituitary. 2007. 10(2):165-72. [Medline].
Daroszewski J, Bolanowski M, Kaluzny M, Siewinski M. The imbalance of cathepsin B-like activity in acromegalic patients--preliminary report. Neuro Endocrinol Lett. 2010. 31(2):256-60. [Medline].
Roelfsema F, Biermasz NR, Romijn JA, Pereira AM. Treatment strategies for acromegaly. Expert Opin Emerg Drugs. 2005 Nov. 10(4):875-90. [Medline].
[Guideline] Katznelson L, Laws ER Jr, Melmed S, et al. Acromegaly: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2014 Nov. 99(11):3933-51. [Medline].
[Guideline] Nainggolan L. New Guidelines for Acromegaly Include Advice on Pregnancy. Medscape Medical News. Nov 10 2014. [Full Text].
Azkur D, Yoldas T, Toyran M, Kocabas CN. A pediatric case of anaphylaxis due to octreotide. Asian Pac J Allergy Immunol. 2011 Dec. 29(4):361-3. [Medline].
Shimatsu A, Teramoto A, Hizuka N, Kitai K, Ramis J, Chihara K. Efficacy, safety, and pharmacokinetics of sustained-release lanreotide (lanreotide Autogel) in Japanese patients with acromegaly or pituitary gigantism. Endocr J. 2013. 60(5):651-63. [Medline].
Sheppard M, Bronstein MD, Freda P, Serri O, De Marinis L, Naves L, et al. Pasireotide LAR maintains inhibition of GH and IGF-1 in patients with acromegaly for up to 25 months: results from the blinded extension phase of a randomized, double-blind, multicenter, Phase III study. Pituitary. 2014 Aug 8. [Medline].
Gadelha MR, Bronstein MD, Brue T, Coculescu M, Fleseriu M, Guitelman M, et al. Pasireotide versus continued treatment with octreotide or lanreotide in patients with inadequately controlled acromegaly (PAOLA): a randomised, phase 3 trial. Lancet Diabetes Endocrinol. 2014 Nov. 2(11):875-84. [Medline].
Sandret L, Maison P, Chanson P. Place of cabergoline in acromegaly: a meta-analysis. J Clin Endocrinol Metab. 2011 May. 96(5):1327-35. [Medline].
van der Lely AJ, Biller BM, Brue T, Buchfelder M, Ghigo E, Gomez R, et al. Long-term safety of pegvisomant in patients with acromegaly: comprehensive review of 1288 subjects in ACROSTUDY. J Clin Endocrinol Metab. 2012 May. 97(5):1589-97. [Medline].
Higham CE, Atkinson AB, Aylwin S, Bidlingmaier M, Drake WM, Lewis A, et al. Effective combination treatment with cabergoline and low-dose pegvisomant in active acromegaly: a prospective clinical trial. J Clin Endocrinol Metab. 2012 Apr. 97(4):1187-93. [Medline].
Rix M, Laurberg P, Hoejberg AS, Brock-Jacobsen B. Pegvisomant therapy in pituitary gigantism: successful treatment in a 12-year-old girl. Eur J Endocrinol. 2005 Aug. 153(2):195-201. [Medline].
Castinetti F, Morange I, Dufour H, Regis J, Brue T. Radiotherapy and radiosurgery in acromegaly. Pituitary. 2009. 12(1):3-10. [Medline].
Weber DC, Momjian S, Pralong FP, Meyer P, Villemure JG, Pica A. Adjuvant or radical fractionated stereotactic radiotherapy for patients with pituitary functional and nonfunctional macroadenoma. Radiat Oncol. 2011 Dec 8. 6:169. [Medline]. [Full Text].
Jagannathan J, Yen CP, Pouratian N, Laws ER, Sheehan JP. Stereotactic radiosurgery for pituitary adenomas: a comprehensive review of indications, techniques and long-term results using the Gamma Knife. J Neurooncol. 2009 May. 92(3):345-56. [Medline].
Espinosa-de-Los-Monteros AL, Sosa E, Cheng S, Ochoa R, Sandoval C, Guinto G, et al. Biochemical evaluation of disease activity after pituitary surgery in acromegaly: a critical analysis of patients who spontaneously change disease status. Clin Endocrinol (Oxf). 2006 Mar. 64(3):245-9. [Medline].
Abe T, Tara LA, Lüdecke DK. Growth hormone-secreting pituitary adenomas in childhood and adolescence: features and results of transnasal surgery. Neurosurgery. 1999 Jul. 45(1):1-10. [Medline].
Ronchi CL, Giavoli C, Ferrante E, Verrua E, Bergamaschi S, Ferrari DI, et al. Prevalence of GH deficiency in cured acromegalic patients: impact of different previous treatments. Eur J Endocrinol. 2009 Jul. 161(1):37-42. [Medline].
van der Klaauw AA, Bax JJ, Roelfsema F, Bleeker GB, Holman ER, Corssmit EP, et al. Uncontrolled acromegaly is associated with progressive mitral valvular regurgitation. Growth Horm IGF Res. 2006 Apr. 16(2):101-7. [Medline].
Thanabalasingham G, Grossman AB. Acromegaly: Beyond surgery. Indian J Endocrinol Metab. 2013 Jul. 17(4):563-7. [Medline]. [Full Text].
Chahal HS, Stals K, Unterländer M, Balding DJ, Thomas MG, Kumar AV, et al. AIP mutation in pituitary adenomas in the 18th century and today. N Engl J Med. 2011 Jan 6. 364(1):43-50. [Medline].
Kannan S, Kennedy L. Diagnosis of acromegaly: state of the art. Expert Opin Med Diagn. 2013 Sep. 7(5):443-53. [Medline].


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From Wikimedia Commons, the free media repository
English: Shinrone is a small town in County Offaly, Ireland. It lies at the junction of the R491 regional road between Cloughjordan to Roscrea where it is joined by the R492. According to the 2006 census the population is 591 persons.
Gaeilge: Baile beag is ea Suí an Róin i g Contae Uíbh Fhailí in Éirinn. Bhí 591 daoine ina gcónaí ann sa bhliain 2006.
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Be Afraid...Be Very Afraid
Be Afraid -- Be Very Afraid
Well, I didn't show you EVERYTHING that I got at the yard sales. I got picture frames, plates, hot curlers, plaques,unique jewelry, curtains, metals and pins from various wars (really -- they're beautiful). All these items together came up to about another $15. OK -- more stuff that I don't need, right? I'll just tuck it away for when I am ready to do that project or perhaps when I'm ready to list it on ebay or maybe my daughter will want it. You see where I'm going.
Did I mention that I watched "Hoarders" last night?
I ALWAYS meet wonderful people at yard sales -- usually the conversation starts with the yard-salee and then evolves to include other yard-salers. You know how it is. Well, somehow I got involved in a conversation about bras with the yard-salee and she said that she had a ton of beautiful bras that she needed to get rid of -- looked like they might fit me she said. Well she brought them over and they were a indeed beautiful, colorful, lacy yet strong bras. I felt uplifted just looking at them - - and I wanted them. I told her that I really didn't need anymore bras, but she obviously saw that look in my eyes. It was covetous, I'm ashamed to say. She simply put them all in a bag and said, "Here, take them."
I took the bras and now I have washed them all with such care and I was admiring them, and wanted to share this wonderful sight with my bloggee friends. Aren't they beautiful? All brand name, of course! Oh -- did I mention...
This is how it begins, folks! I'm just telling ya! This is how it all begins.....


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Disney Fantasia: Music Evolved trailer shows Kinect gameplay
Disney Fantasia: Music Evolved developer Harmonix has released a new trailer for its motion controlled music game.
As you can see, the film's original score can be mixed with modern music along with classic Disney visuals. There's around 30 tracks in all, including such artists as Queen and Bruno Mars.
What do you think about this new spin on the classic? Leet us know below.
Disney Fantasia: Music Evolved out 2014 on Xbox 360 and Xbox One.
Via Destructoid.
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Check prices on hotels in Capel Manor College and Gardens
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Multiple news outlets, including ESPN and OrangeBloods.com, are reporting that the Texas Longhorns have decided to stay in the Big 12. Oklahoma, Oklahoma State and Texas A&M also agreed to stay in the league.
Texas had been contemplating a move to the Pac-10, with Oklahoma, Oklahoma State and Texas Tech following whatever path the Longhorns chose. But Texas has decided to stay put in the Big 12 in light of a new television deal that could earn the Longhorns $20 to $25 million per year.
The Texas A&M Aggies were rumored to join the SEC if the Longhorns bolted to the Pac-10. Their decision to stay in the Big 12 will net them about $20 million per year in TV revenue, as will the Oklahoma Sooners.
There has been no word yet on whether the Big 12 will try to add two additional schools to bring their number back to 12. Without 12 schools, the conference cannot stage and profit from a championship game.
Meanwhile, the Utah Utes may now be sought after to join the Pac-10, which currently stands at 11 schools after the recent addition of Colorado. It is believed that the Pac-10 wants to get to 12 schools in order to hold their own conference championship game.
According to Dan Beebe, the Big 12 is not looking to expand. There were some rumors about Arkansas joining the Big 12, but the Arkansas AD issued a press release today stating they are staying in the SEC.
My understanding concerning the Big 12 championship game is that Beebe may petition the NCAA for a waiver to continue the game, even with 10 teams in the conference. That is if the Big 12 wants to continue the game.
move OU and OSU to north division and invite tcu and la tech(ikr LOL) to make it a 12 conf again
that would be bad a#@!!!
Sorry BIGDAWG but T.C.U. went to the Big East. Maybe Ark. and Houston.
Big 12 will have to do something. If they choose not to add 2 more teams the Big 12 will be a thing of the past………
If OU and OSU went to the north, I wonder who would go to the championship to represent the south every year? Apart from to occasional Texas Tech, Texas would be a constant. I prefer my Cowboys over Sooners, but Texas-OU game is always a good game, and usually decides the south's champ. Osu going North would be a good thing, because it would actually produce a decent contender for the title. Nebraska was the only legitimate power in the north with a rare Kansas State or Missouri being good. In the South, you have 3 schools that are historic powerhouses in Texas, OU, and Texas A&M. Oklahoma State and Texas Tech are on the rise to become powerhouses. In the North, now Nebraska is gone, the only two teams with good programs are Kansas State and Missouri. Basically, the south is like the SEC and the North is like the WAC, with Mizzou and Kansas State being Boise and Nevada, respectively.


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An extension of the standard probably approximately correct (PAC) learning model that allows the use of generalized samples is introduced. A generalized sample is viewed as a pair consisting of a functional on the concept class together with the value obtained by the functional operating on the unknown concept. It appears that this model can be applied to a number of problems in signal processing and geometric reconstruction to provide sample size bounds under a PAC criterion. A specific application of the generalized model to a problem of curve reconstruction is considered, and some connections with a result from stochastic geometry are discussed
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Fearless Foodies Message Board › Please confirm your RSVP for Hors d'oeuvres & Cocktail Pairings
Group Organizer
Austin, TX
Hi All!
I am REALLY excited about this one! Please confirm your RSVP for this Saturday by letting us know what you plan to bring as your Hors d'oeuvres & Cocktail Pairing. You can post this in the "Talk About This Meet-up" section or add the content to your RSVP.
If it looks like you won't be able to make it, please change your RSVP to no so someone on the wait list can move up. We have a hefty wait list, so please be considerate and come if you committed.
For your cocktails, let stay conservative on the portion size. Remember this is a mini tasting so let's keep them to about a 2 oz shooter size. Don't worry about being skimpy on your portions, we will be sampling 17 different cocktails. No one's going home thirsty
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Four arrested in car burglaries
Published: Thursday, June 24, 2010 at 7:11 p.m.
Last Modified: Thursday, June 24, 2010 at 7:11 p.m.
HOUMA — Deputies arrested three adults and one teenager Wednesday in connection with a rash of car burglaries.
Blake Crochet, 20, 135 Blakefield Drive, Schriever; Jessie Adams, 21, 231 St. Malo St., Houma; James Olivier, 20, 219 Hummingbird Court, Houma; and a 15-year-old boy were each charged, according to the Terrebonne Parish Sheriff's Office.
Deputies identified the suspects using a resident's private surveillance footage while investigating burglaries of unlocked cars in Lisa Park, Wallace Thibodaux Estates in Bayou Blue and Southern Estates in Gray. A detective recognized them in the video, said Maj. Malcolm Wolfe, a Sheriff's Office spokesman.
The deputies later found dozens of stolen items at 219 Hummingbird Court, including GPS devices, car stereos, laptop computers, cell phones, iPods and firearms, Wolfe said.
Crochet and Olivier were charged with seven counts of simple burglary, the 15-year-old with three counts and Adams with one count. Deputies are withholding the teenager's name because of his age.
The burglaries are still under investigation. If you have information, call the Sheriff's Office detective bureau at 876-2500.
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March 29, 2013
| Table of Contents
Spring/Summer 2013 Special Parent
Inspiration & Support
• Inspiration From Around the Web
• Autism Speaks Co-Founder Highlights Succesess in NY and Beyond
• Voices for Change: Speak Up for Kids 2013 Campaign for Mental Health Care
• Helping is Healing: How One Mom Aids Other Parents of Kids with Special Needs
• Son, Love Thyself: Help Your Boy with ADHD Improve His Self-Esteem
Plus: 10 Steps to Build Your Son's Self-Esteem
Expert Advice & News
Homegrown Heroes in Your Neighborhood
• NYC: Singing and Signing for Good with Kids with Down Syndrome • NYC: Helping Kids Soar on a Swing Made for Wheelchairs • Long Island: Teaching Children with Autism How to Surf• Suburbs: The Gift of Friendship Promotes Inclusion of Children with Special Needs
Affordable Care Act
• How Obamacare Impacts Your Finances • What You Should Know About Special Needs Trusts
On Autism
• Autism & Epilepsy: The Latest Research on the Link
• Autism Awareness: Ways To Get Involved
Talking Meds
• The Importance of Talking to Your Child About His Prescriptions
School Choice
• Top 10 Things to Look For in a School for Your Child with Special Needs
• Selective Mutism Signs, Symptoms, and Resources
In the Magazine: July 2016
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Party Planning
After-School Activities
Camp Guide
Sports for Kids
Child Care Options
Education Resources
Family Health Guide
Special Needs Guide
Jul 22, 2016
Jul 20, 2016
Jul 19, 2016
Jul 21, 2016
Jul 11, 2016
Jun 22, 2016
Jul 07, 2016
Jun 07, 2016
Carla Naumburg, Ph.D., author of "Parenting in the Present Moment," shares what mindfulness is and how parents can apply it in messy real life situations.
Chess is an excellent course of study to promote essential life skills. Centers like NY Chess Kids offer after-school and other programs to teach children the game of chess.
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